Flash Glucose Monitoring Research Articles (Page 1)

Resistance exercise provides numerous health benefits, including improved glucose control and enhanced muscular strength. However, it remains unclear whether the time of day resistance exercise is performed affects these benefits. The objective of this work was to determine the effect of time of day on muscle and metabolic responses to resistance exercise training in young healthy adults. The study included 36 participants (30±7 years old; and 28±4kg/m2) who were randomised into control, morning (06.00-10.00h) or evening (16.00-20.00h) groups. Exercise groups performed eight resistance exercises, 3 times per week, for 6weeks, at their allocated time. At baseline and post-intervention, insulin sensitivity, flash glucose monitor data, muscle strength and vastus lateralis muscle thickness were measured. Over the 6-week intervention, there were significant main effects of time on insulin sensitivity (P<0.001), muscle thickness (P=0.008) and knee extensor maximal torque (P<0.001), indicating improvements with resistance exercise training. However, there were no significant time × group interactions for any outcome measures (insulin sensitivity P=0.206, muscle thickness P=0.279, knee extensor torque P=0.151), demonstrating that exercise timing did not differentially affect training adaptations. Both exercise groups showed similar improvements compared to controls, regardless of whether training occurred in the morning or evening. No significant effects were observed for flash glucose monitor data. This study highlights the benefits of resistance exercise and demonstrates that timing has little influence on these effects. Promotion of resistance exercise at convenient times is recommended. This study was registered at ClinicalTrials: ClinicalTrials.gov ID: NCT05321914.

The aim of this work was to assess the effect of video consultations over 1 year compared with usual care for patients with type 1 diabetes treated with insulin pumps, with time in range (TiR) as the primary outcome measure. We carried out a 52 week, open label, randomised, controlled superiority trial including adult type 1 diabetes patients treated with insulin pumps. Participants were recruited from the Hospital of Southern Jutland and were adult patients, diagnosed with type 1 diabetes mellitus who had used an insulin pump for at least 6 months. Participants were randomised to video consultations (intervention) or physical consultations (control) using a computer-generated block randomisation sequence in a 1:1 allocation, stratified for sensor type (continuous glucose monitor and flash glucose monitor, respectively).Since this was an 'open-label' trial, neither the healthcare professionals providing the treatment nor the participants were blinded to allocation after randomisation. The primary outcome measure was the percentage of TiR (glucose levels 3.9-10.0 mmol/l) from week 51 to 52, measured by continuous glucose monitoring. Continuous endpoints were analysed using ANCOVA, with randomised treatment and stratification groups as fixed effects and the baseline value as a covariate. Missing data in the intention-to-treat (ITT) population were addressed using multiple imputation. Of the 76 randomised participants (ITT population, 38 per group, median age 49 years, 51% women), 32 participants in the intervention group and 31 in the control group completed the study. Least square means TiR at 1 year was 64.3% in the video group and 63.5% in the control group, with a clinically insignificant difference of 0.8 percentage points (95% CI -5.3, 6.9; p=0.25). For secondary outcomes, the video group was superior in terms of treatment satisfaction and reduction in HbA1c. However, the video group experienced an inferior impact on quality of life. Video consultations did not significantly improve the primary endpoint. However, compared with control, the intervention was associated with superior treatment satisfaction and a favourable effect on HbA1c, albeit with an inferior impact on quality of life. ClinicalTrials.gov NCT04612933 FUNDING: The study received funding from Knud and Edith Eriksens Mindefond. The Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital is supported by a core grant from the Oak Foundation.

Disclosure: K. Kato: Chubu Electric Power Co., Inc., Oishi kenko Inc., Abbott Japan LLC, Kurabo Industries Ltd. K. Kinouchi: Chubu Electric Power Co., Inc., Oishi kenko Inc., Abbott Japan LLC. K. Kiyono: Kurabo Industries Ltd., JSR Corporation. H. Itoh: Chubu Electric Power Co., Inc., Oishi kenko Inc., Abbott Japan LLC. K. Hayashi: Chubu Electric Power Co., Inc., Oishi kenko Inc., Abbott Japan LLC.The circadian rhythm of living organisms is a near 24-hour cycle of self-sustainable variations under the constant condition. This is primarily driven by the biological clock which operates through the transcriptional-translational feedback loop at the cellular level and governs metabolism, behavior, and endocrine functions. Circadian rhythm disruption is associated with a wide array of pathophysiology such as obesity, cancer, and neurological disorders. While the central clock in the hypothalamus is reset by light, the peripheral clock is entrained by metabolic inputs such as food and exercise. In addition to such environmental cues, psychosocial factors comprising family status, working schedules, commuting hours, among others presumably impinge on temporal patterns of behavior, thereby contributing to circadian misalignment in humans. Whereas the impact of a given zeitgeber (time-giver) on human circadian physiology needs to be evaluated in the laboratory setting, the impact of such modern and urban types of environmental perturbations can only be assessed under real-world and uncontrolled conditions in light of the inherent and complex nature. In recent years, IoT technology allows us to continuously measure biological information (e.g., heart rate and estimated blood sugar levels). In this study, we aimed to examine the potential entrainment factors uniquely in humans which dictate human biological and behavioral rhythms in real-world environments.25 patients undergoing outpatient treatment at the Division of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of Medicine were recruited. The home environmental parameters (e.g., temperature, humidity, light intensity, noise, atmospheric pressure, and so on) were collected using environmental sensors, and biometric information (e.g., heart rate, subcutaneous glucose concentrations) was measured using wearable devices and flash glucose monitoring. Daily eating behavior was recorded using a mobile app. The information obtained from these modalities were integrated and visualized to examine their periodicity and characteristics. The average age of the subjects was 62.3, and diabetes, dyslipidemia, hypertension were noted in 80% of the study participant. The average BMI and HbA1c were 25.3 kg/m2 and 6.5%, respectively. Using the Cosinor analysis, daily rhythm was confirmed in the heart rate and glucose levels, as well as environmental parameters such as temperature and humidity. Thus, wearable sensing devices and mobile apps have enabled us to continuously monitor and perform the rhythmic analyses of human metabolism, behavior, physiology, and environment, and may open a new avenue for better understanding of the human circadian pathophysiology underlying individual lifestyle patterns.Presentation: Saturday, July 12, 2025

The discordance between glycated haemoglobin (HbA1c) and the glucose management indicator (GMI) has been proposed as a marker of vascular risk in diabetes. This study evaluated whether the GMI/ HbA1c ratio independently predicts diabetic retinopathy (DR) in adults with type 1 diabetes (T1D) using continuous glucose monitoring. We conducted a multicenter cross-sectional study involving 1,070 adults using flash glucose monitoring. Participants were stratified as high glycators (ratio < 0.9) or non-high glycators based on the GMI/HbA1c ratio. DR status was assessed by ophthalmologic evaluation. Multivariable logistic regression and 1:1 propensity score matching were used to assess independent associations with DR, adjusting for age, sex, diabetes duration, smoking, hypertension, LDL cholesterol, BMI and insulin dose. While high glycators had a higher crude DR prevalence (31.3% vs. 23.1%, p = 0.020), the GMI/HbA1c ratio was not independently associated with DR in adjusted models (OR 1.19; 95% CI: 0.34–4.15; p = 0.785) or in the matched cohort (OR 1.23; 95% CI: 0.76–1.99; p = 0.391). Absolute HbA1c remained the strongest glycemic predictor. These findings suggest that the GMI/HbA1c ratio may aid in interpreting discordant glycemic profiles, serving as a contextual tool in clinical practice, but it lacks independent prognostic value for DR.

Flash glucose monitoring (FGM) systems provide real-time interstitial glucose readings and offer a reliable alternative to capillary self-monitoring of blood glucose. This technology may improve diabetes management and quality of life (QoL) for individuals with type 1 diabetes mellitus. This prospective cohort study employed both qualitative and quantitative approaches to assess patient satisfaction, perceived user experience, glycemic control metrics, and QoL among adults with type 1 diabetes mellitus newly enrolled in the Federal District’s public FGM program in Brazil. Participants completed questionnaires, including the Brazilian version of the Diabetes Quality of Life Measure, at baseline and after 3 months of FGM use. Of the 83 enrolled patients, 69 completed the study, of whom 14 were excluded because of incomplete follow-up questionnaires. After 3 months of FGM use, the mean time in range was 68.96% and the mean glucose management indicator was 6.69%. A coefficient of variation of ≥ 36% was observed in 60.9% of the participants, with an average sensor scan frequency of 14.27 scans/day. The mean age was 33.8 years (SD = 9.4), and 50.7% of participants were female. Participants reported higher satisfaction with FGM than with self-monitoring of blood glucose, citing perceived improvements in comfort, practicality, diabetes management, and overall QoL. However, while QoL scores improved slightly after 3 months of FGM use, these changes were not statistically significant. FGM use was associated with high patient satisfaction and positive experiential feedback. Although QoL outcomes did not change significantly, the findings suggest perceived benefits in diabetes self-management among users.

BACKGROUND: Women with type 1 diabetes mellitus (DM) have a high frequency of menstrual irregularities and perinatal complications. New methods for monitoring the glycemic profile provide opportunities to analyze the effectiveness of insulin therapy regimens in maintaining the reproductive health of these patients.AIM: The aim of the study was to assess the relationship between glycemic profile patterns, pro- and antioxidant statuses, and ovarian reserve parameters in type 1 DM patients.MATERIALS AND METHODS: This study included 60 type 1 DM women, of whom 30 patients aged 33.0 [30.0; 35.0] years used the multiple insulin injections (MII) regimen (Group 1). In this group, patients were divided into two subgroups: not exceeding the percentage of hyperglycemia above the target range for more than 35% of the day (Group 1A) and exceeding this range (Group 1B). The continuous subcutaneous insulin infusion (CSII) regimen was administered to other 30 patients (Group 2). They were subdivided identically into Groups 2A and 2B. We analyzed continuous glucose monitoring data using the FreeStyle Libre Flash Glucose Monitoring System and evaluated blood malonic dialdehyde level, catalase activity and 3-nitrotyrosine level, as well as ovarian volume, antral follicle count, anti-Müllerian hormone and follicle-stimulating hormone levels.RESULTS: We found no differences in the time in range in Groups 1A and 2A. The HbA1c level was higher in the time above range group of women using MII. Blood 3-nitrotyrosine level in Group 1B was 161.4 [110.6; 232.1] nmol/l and differed from that in Group 2B (42.4 [19.1; 64.9] nmol/l; p&lt;0.01). A relationship was found between catalase activity and soluble receptor for advanced glycation end-products (sRAGE) levels in Group 2A (rs=0.857; p&lt;0.05). The antral follicle count tended to increase when the target range of glucose levels was exceeded above 7.8 mmol/l for more than 35% of the day.CONCLUSION: Preliminary data were obtained on the relationship between hyperglycemia exceeding 7.8 mmol/l for more than 35% of the day with oxidative stress parameters, sRAGE levels, and a tendency towards an increase in the antral follicle count in women with type 1 DM.

AimTo study the effectiveness of the flash glucose monitoring (FGM) system in the monitoring of blood glucose in patients after renal transplantation.MethodsOne hundred and fifteen patients who underwent renal transplantation at the Renmin Hospital of Wuhan University from January to December 2021 were selected for the study, with patients from January to June as the control group (n = 62) and patients from July to December as the observation group (n = 53). The control group used traditional finger blood collection to monitor blood glucose, while the observation group used FGM system to monitor the patients' blood glucose. The Digital Pain Rating Scale (NRS) and the Glucose Monitoring System Satisfaction Questionnaire (GMSS) were used to compare the pain associated with glucose needling and patient satisfaction with the glucose monitoring equipment, and compared the incidence of abnormal blood glucose events and adverse events between the two groups.ResultsThe differences in pain comparison, satisfaction with the blood glucose monitoring equipment, the number of abnormal blood glucose events and adverse events between the two groups were statistically significant (p < 0.05).ConclusionThe application of FGM system enables continuous glucose monitoring and management of patients in the early post-transplant period, reduces the painful pinprick of glucose monitoring, detects glucose abnormalities early, reduces adverse events and improves patient satisfaction.

Introduction. Glycemic control is a primary goal in the prevention of vascular complications in diabetes mellitus. Diabetic retinopathy is a common complication of diabetes mellitus. Ultrasound diagnostics makes it possible to safely assess changes in retrobulbar blood flow during glycemic control in patients with type 1 diabetes mellitus at a young age.Aim: To evaluate association between glycemic control parameters and hemodynamic changes in retrobulbar blood flow in patients with type 1 diabetes mellitus at a young age.Material and Methods. The study included data from 161 children aged 7–17 years with type 1 diabetes mellitus and glycosylated hemoglobin level more than 7.5%. All patients underwent ophthalmic ultrasound examination. Glycemic control was assessed using flash glucose monitoring technology.Results. The study showed a statistically significant difference in glycemic control (p &lt; 0.05) in patients with reduced retrobulbar blood flow comparing with a group of patients with unchanged blood flow through the retrobulbar vessels. Patients with reduced retrobulbar blood flow were characterized by an increase in the percentage of glycemic events above and below the target glycemic range (p = 0.000) and a decrease in the percentage of glycemic events within the target glycemic range (p = 0.000). A correlation was established (p &lt; 0.05) between changes in glycemic control indicators and a decrease in blood flow through the retrobulbar vessels.

Postprandial hypoglycemia induced by Dumping Syndrome (DS) represents a side effect of bariatric surgery linked to glucose-dependent hyperinsulinemia, which can cause serious symptoms 2-3 hours after the meal hypoglycemia. This clinical case shows the effectiveness of semaglutide, a long-acting GLP1 receptor agonist, in one patient previously subjected to gastric bypass (GBP), with persistent late postprandial hypoglycaemic symptoms occurring after surgery. A female patient, 31 years old, subjected to GBP 10 years earlier, with the diagnosis of diabetes, was admitted to our unit for persistent post-prandial reactive hypoglycemia, confirmed by Flash Glucose Monitoring (FGM) FreeStyle. The patient was intolerant to metformin, had been treated with acarbose with poor results. HbA1c 7.9%. Acarbose was suspended, and semaglutide was started sc at increasing doses, 0.25 mg/week for 1 month and subsequently 0.5 mg/week. After the first few weeks, symptoms of DS were significantly reduced with improvement of the daily glycemic profile and disappearance of hypoglycemic events. The time-below range, time spent with blood glucose <70 mg/dl, decreased by 12% to 4% during treatment with semaglutide 0.25 mg/week, up to 1% with a dose of 0.5 mg/week. The effect of the drug on reducing hypoglycemic episodes was persistent for up to 8 months. Treatment of post-bariatric reactive hypoglycemia includes nutritional therapy, the use of glucosidase inhibitors, and somatostatin analogues. The use of short-acting GLP-1RA analogues has also recently been reported. In our patient, therapy with semaglutide s.c. significantly reduced episodes of reactive hypoglycemia with an improvement in the quality of life.</p>.

Background:The key to salvaging free flaps following postoperative hemodynamic compromise is early detection and prompt intervention. Although clinical examinations, such as observing flap color, are often used for monitoring, they are subjective and have limited accuracy. This underscores the need for a low-cost, simple, and objective alternative. A potential solution is the use of a flash glucose monitoring (FGM) system for flap monitoring. In this study, we retrospectively investigated whether FGM is beneficial for monitoring flap blood flow.Methods:We retrospectively evaluated the medical records of patients who underwent breast reconstruction using a deep inferior epigastric perforator flap transfer. An FGM sensor was applied to each monitoring flap, and interstitial fluid glucose (IFG) levels were measured regularly during a 7-day postoperative period.Results:A total of 37 flaps were evaluated. Five flaps required surgical revision due to hemodynamic compromise; 1, in a patient with diabetes, completely failed, whereas 3 were successfully salvaged. The remaining flap developed arterial occlusion on the sixth day and was partially necrotic. In all cases requiring revision, except for the patient with diabetes, IFG levels dropped to less than 40 mg/dL before any clinical examination changes were observed. The IFG cutoff value, defined as less than 40 mg/dL, was calculated to have 100% sensitivity and 91% specificity within 48 hours postoperatively, with a negative predictive value of 100%.Conclusions:Measuring IFG using FGM is a noncontact, simple, and low-cost method. This method can provide a highly effective screening method for human and economic resource use.

Background:The physiological changes during Ramadan in people with type 2 diabetes (T2D) are not well described in the literature. However, advances in technology have created new frontiers to understand these changes. This study aims to understand the impact of Ramadan fasting on blood glucose excursion, vital signs, and physical activities in people with T2D who are on three or more antidiabetic medications.Methods:This prospective observational study was conducted at Hamad General Hospital, National Diabetes Centre, between February 1, 2020 and May 30, 2020 (covering three months before and including the month of Ramadan). We included people with T2D who were on three or more antidiabetic medications. Medications were adjusted during Ramadan based on international guidelines. Flash glucose monitoring and Fitbit devices were used to monitor glucose levels and physical activity. The primary outcomes were changes in time in range (TIR), time above range (TAR), and time below range (TBR) before and during Ramadan.Results:We included 18 patients with T2D, of whom 13 were males (72.2%). The mean age was 51.2 years (SD 7.4), the mean HBA1c was 7.8% (SD 1.0), and the mean duration of T2D was 12.5 years (SD 3.1). There were no significant changes in TIR, TAR, and TBR before and after Ramadan. There was no statistically significant difference in the TIR, TAR, and TBR during fasting hours and after iftar. However, the ambulatory glucose profile shows a reduction in glucose levels during fasting hours, reaching a nadir just before iftar, followed by a prolonged period of hyperglycemia post iftar. Physical activity levels decreased during fasting hours but increased approximately one hour before iftar. Multilinear regression analysis showed a positive correlation between engaging in vigorous physical activity and the TBR during fasting hours [β-coefficient (95% CI): 0.26 (0.07–0.45), p < 0.05].Conclusion:Our findings show no significant changes in the overall glucose profile, except for prolonged post-iftar hyperglycemia. Intensive physical activity during fasting hours can increase the risk of hypoglycemia. This studyhighlights the need for further in-depth research to better understand the impact of lifestyle changes on blood glucose excursion during Ramadan.

BackgroundStructured diabetes education plays a crucial role in the management of Type 1 Diabetes (T1D), especially with advanced technologies such as continuous subcutaneous insulin infusion (CSII). This study evaluates the impact of tailored education on adherence and glycemic control among pediatric CSII users.Patients and methodsThis interventional analytical study included 30 patients diagnosed with T1D with age ranged from 5 to 18 years, recruited from Diabetes & Endocrinology Clinic at tertiary university-based children’s hospital. Patients were recruited for one year duration. Patients who were on multiple daily injection (MDI) for 2 to 10 years were shifted to CSII after receiving comprehensive diabetes education. Their education level was assessed individually using a questionnaire to assess patients’ knowledge and application skills at the time of insulin pump insertion, 3 and 6 months later. Twenty-five patients were on mini-med 715, 10 patients used flash glucose monitoring, and 15 patients used self-monitoring blood sugar, while five patients were on mini-med 780G and continuous glucose monitoring (CGM) using guardian 4 (G4).ResultsStudy included 19 females (63.3%) and 11 males (36.7%) with age ranged from 7 to 11 with mean ± SD of 10.74 ± 1.86. Patients’ education level was assessed before pump insertion, and 3 months later which shows significant improvement in patients’ diabetes knowledge and technical skills with P-value 0.038. Also, time in range (TIR) improved significantly in well-educated patients at 3 and 6 months with P-values 0.048 and 0.025 respectively. There was highly significant improvement of HbA1c after 6 months (8.82 ± 1.5 vs. 7.18 ± 0.56) with P-value 0.000 after receiving diabetes education.ConclusionsTailored diabetes education significantly improves adherence and glycemic outcomes in pediatric patients using CSII. Integrating structured educational programs with diabetes technology is essential to achieve optimal metabolic control in youth.

ABSTRACTAims/IntroductionGlucotoxicity exacerbates hyperglycemia by impairing insulin secretion and sensitivity, necessitating effective interventions. Although short‐term intensive insulin therapy (SIIT) mitigates glucotoxicity, the effect of combining SIIT with sodium‐glucose co‐transporter 2 (SGLT2) inhibitors in hospitalised type 2 diabetes mellitus (T2DM) patients with severe hyperglycemia remains unclear. Herein, we aimed to evaluate the efficacy and safety of combining SGLT2 inhibitors with basal bolus therapy (BBT) for glycemic control in hospitalised patients with T2DM.Materials and MethodsIn this randomised, open‐label, single‐centre trial, 35 eligible T2DM patients hospitalised for treating hyperglycemia were allocated to the BBT (n = 17) or BBT with empagliflozin (BBT + E) groups (n = 18). Patients were monitored for 7 days using flash glucose monitoring. The primary outcome was time‐in‐range (TIR, 70–180 mg/dL). The secondary outcomes included time‐above‐range (TAR), time‐below‐range (TBR), daily glucose levels, total daily insulin dose and ketone body concentration.ResultsThe BBT + E group exhibited a significantly higher TIR from day 2, which exceeded 70% by day 5, with reduced TAR and insulin requirements. Blood glucose levels declined more rapidly in the BBT + E group, accompanied by a modest ketone elevation without severe ketoacidosis. The TBR increased marginally on day 7, primarily nocturnally; but no symptomatic hypoglycaemia occurred.ConclusionThe addition of SGLT2 inhibitors to BBT significantly improved early glycaemic control and reduced insulin requirements without severe ketone elevation in hospitalised T2DM patients. Routine monitoring of ketone levels and careful insulin titration are critical to ensure safety.

Controlled laboratory studies have demonstrated that breaking up sitting can reduce postprandial glucose in South Asian adults. This study examined the effects of substituting sitting with standing and walking on interstitial glucose in South Asian individuals under free-living conditions. South Asian adults (n = 14 [50% male]; body mass index 26.5 ± 0.8kg·m-2) aged 41 ± 3years completed two, 4-day regimens in a counter-balanced order: (1) SIT (restrict walking and standing to ≤ 1h/day each) and (2) SITless (substitute ≥ 5h/day of sitting with ≥ 3h of standing and ≥ 2h of walking, and interrupt sitting every 30min). Interstitial glucose was measured using Flash glucose monitoring. Sitting and physical activity were measured with the activPAL3. Outcomes were compared between regimens using linear mixed models. Interstitial glucose net incremental area under the curve (iAUC) for waking hours was lower by - 9.2mmolL-1·16h-1(95% Confidence Interval [CI]: - 18.1, - 0.3) in SITless than SIT (p = 0.04), while lunch postprandial glucose iAUC was significantly lower by -1.0mmolL-1.2h-1 (95% CI - 1.8, 0.2) in SITless (p = 0.02). There were no significant differences in other 24h or 16h glucose metrics (p ≥ 0.06). Compared to SIT, sitting was lower by - 3.6h/day (95% CI - 4.9, - 2.3) in SITless (p < 0.01). Standing and stepping time were higher by 1.9h/day (95% CI 0.6, 3.2) and 1.6h/day (95% CI 1.2, 2.1) in SITless (p ≤ 0.01). Substituting sitting with standing and walking under free-living conditions can be used to effectively attenuate glycaemia during waking hours, but not across 24h, in South Asian adults. NCT04645875..

Gestational diabetes mellitus (GDM) is hyperglycemia diagnosed for the first time during the second or third trimester of pregnancy. It often leads to neonatal complications. Effective management of GDM is crucial to mitigate such risks. This study evaluates the effectiveness of ambulatory glucose profile (AGP) vs self-monitoring of blood glucose (SMBG) in managing GDM. This 18-month observational study was conducted at All India Institute of Medical Sciences, Raipur, India, involving 65 pregnant women diagnosed with GDM. Thirty-two patients wore the flash glucose monitoring system (AGP group) and 33 performed SMBG (SMBG group). Blood glucose levels were monitored using AGP and SMBG, with data collected on fasting, postprandial glucose levels, and hypoglycemic events till 15 days after enrollment. Statistical analysis was performed using IBM Statistical Package for the Social Sciences (SPSS) version 21. The AGP group showed significant reductions in blood glucose levels across all measured times. Mean blood glucose concentrations decreased significantly in both groups from enrollment till 15 days, with no significant intergroup differences. The AGP group had a higher mean time in range (92 vs 90%) and lower time above range (4 vs 6%) compared to the SMBG group. Hypoglycemic events were fewer in the AGP group. AGP demonstrated superior effectiveness in managing GDM by providing continuous glucose monitoring, improving glycemic control, and reducing hypoglycemic events compared to SMBG. AGP is recommended for better glucose management in GDM patients.

The most prevalent condition affecting the metabolism of carbohydrates during pregnancy is gestational diabetes mellitus (GDM). Continuous glycemia monitoring systems that use sensors are currently replacing the conventional self-monitoring of glycemia with a glucometer. Poland's insurance coverage has made new technologies possible for continuous glycemia monitoring. Our retrospective study compared the effects of two glycemic measurement techniques on patient preferences and maternal and pediatric clinical outcomes: traditional methods using a glucometer and utilizing a sensor for scanning continuous glycemic monitoring (flash glucose monitoring, or FGM). In a retrospective analysis of 277 women with GDM treated in the Department of Metabolic Diseases, University Hospital in Cracow, Poland, in January 2023 we compared the effectiveness of using of sensor FreeStyle Libra (FGM) vs self-blood glucose monitoring (SBGM) by glucometer in improving clinical maternal outcomes measured by daily insulin dose, body weight gain, mean blood glucose and newborns outcomes assessed by body weight, APGAR score, caesarean sections. We examined 224 women from the SBGM group, 53 from the FGM group, and 277 from the GDM ladies. The SBGM group was diagnosed with GDM later in pregnancy [24 (10-25) vs 11 (8-23.5) weeks; p < 0.001], was admitted at the first pregnancy visit [26 (14-29) vs 20 (12-27) weeks; p = 0.001], and was slightly older [33 (30-36) vs 32 (29-34) years; p = 0,027]. The pre-pregnancy body weight [70 (60-83) vs 67 (59-79) kg; p = 0.358] and the number of pregnancies [2 (1-3) vs 2 (1-3); p = 0.118] did not differ between the two groups. Women who used SMGB gained less weight throughout pregnancy [10 (5.5-13.0) vs 12 (8-14.8) kg; p = 0.0333] and had fewer prenatal checkups [5 (4-7) vs 8 (5-9) weeks; p < 0.001], including fewer teleconsultations [1 (0-3)]. Women in the FGM group received insulin treatment earlier [15 (11.5-27) vs 27 (16-30) week of pregnancy; p < 0,001] and used it more often [52 (98.1%) vs 183 (81.3%); p = 0.005]. There was no significant difference in daily insulin dose per kg of weight [26.5 (11.5-39.2) vs 21 (9-39) U/d; p = 0.325]. The groups did not differ in birth weight [SBGM 3243 ± 485 vs FGM 3331 ± 359 g; p = 0.206] and a gestational week at delivery [38 (38-39) vs 39 (38-39) week; p = 0.092], There was no difference in obstetric outcomes: caesarean sections, preterm births, week of delivery, mean birth weight or prevalence of perinatal complications. When comparing traditional SBGM to flash continuous glucose monitoring in this real-world observation, we have found no changes in the outcomes for mothers and newborns between the groups. There were more teleconsultations for women who used FCGM.

Aim Technology is seen as a potential tool to improve the management of diabetes although few studies have examined sensor use within psychiatric populations. This study investigated the integration of glucose sensors for patients’ diabetes and severe mental illness. Methods The study applied a mixed methods convergent design with focus on glucose monitoring implementation. Quantitative data collected (n = 15) summarized patient characteristics and sensor use over time. Changes in HbA1c levels were also monitored. Qualitative data was collected using semi-structured interviews and focus groups capturing the experiences of patients (n = 10) and clinicians (n = 7) respectively. Results Users utilized data from sensors to facilitate diabetes management although sensor use decreased over time. Analysis from patient interviews constructed three themes: ‘Sensor use – improved awareness of blood glucose’, ‘Sensor use – promoting sharing of glucose readings’, and ‘Sensor use – increased visibility and public awareness of diabetes’. Focus groups with clinicians described two themes: ‘Perceived treatment benefits gained from glucose sensors’, and ‘Treatment challenges posed by glucose sensors’. Conclusion Results indicated that sensors were accepted and meaningfully integrated into clinical practice within this population. Patients and clinicians were largely positive about the integration and usefulness of sensors in diabetes management although some challenges were described.

Attaining an adequate glycemic control has been associated with a better prognosis and with a reduction in the risk of developing long-term microvascular and macrovascular diabetic complications. Continuous glucose monitoring (CGM) has been shown to improve glycemic control and reduce blood glucose variability. Furthermore, CGM is associated with greater treatment adherence and higher satisfaction. Hypoglycemia is the most frequent acute complication in individuals with insulin treated diabetes and may limit the achievement of glycemic control. Furthermore, repeated episodes of hypoglycemia, particularly when a severe hypoglycemia event occurs are associated with adverse outcomes. The introduction of glucose alarms improves not only safety of subjects, but also contributes to improve glycemic control. However, depending on the glycemic thresholds, the frequency of alarms could be perceived as excessive, leading to a state of 'alarm fatigue', limiting the effective response to the alarms by the individual. The optimization of alarm thresholds tailored to individual needs and preferences can enhance the clinical utility of CGM while minimizing alarm fatigue. When alarms occur, their underlying causes should be investigated to enable appropriate corrections and adjustments. CGM systems equipped with alarms, such as FreeStyle Libre 2, have demonstrated efficacy in reducing hyperglycemia and severe hypoglycemic events, leading to improvements in time in range and quality of life of people with diabetes.

Diabetes poses a significant health challenge in Egypt. This review examines the current state of diabetes technology adoption in the country, identifies obstacles hindering wider adoption, and proposes solutions for improvement. The Egyptian government has demonstrated a commitment to diabetes management through initiatives like the “100 Million Health” campaign, which provides free screening for diabetes and other noncommunicable diseases. While there has been progress in implementing technologies such as flash glucose monitoring and continuous glucose monitoring (CGM), adoption rates lag behind those of other countries with similar socioeconomic conditions. A major barrier to diabetes technology adoption is the high cost and limited accessibility, particularly for lower-income individuals. Furthermore, there is a need for increased education and awareness among both patients and healthcare professionals about the benefits and proper use of these technologies. To address these challenges, policymakers should consider implementing policies to enhance affordability and accessibility, such as copayment systems or expanded insurance coverage. Integrating various diabetes technologies, including insulin delivery systems, CGM, and mobile health applications, into a comprehensive platform could significantly improve diabetes management outcomes. Increased utilization of telemedicine and mobile health technologies offers promising prospects for improving patient engagement, access to care, and remote management, especially in underserved rural areas.

Background: This study aimed to evaluate the achievement rates of core glycemic metrics derived from Ambulatory Glucose Profile (AGP) reports among Korean adults with type 1 diabetes using the FreeStyle Libre 1 Flash Glucose Monitoring (FGM) system. The findings are intended to provide foundational data for CGM-based diabetes education and management guidelines.Methods: A retrospective observational study was conducted among 510 adult patients with type 1 diabetes who received outpatient care at three tertiary hospitals in Seoul between June 1 and 14, 2024. Data were collected from electronic medical records and LibreView CGM uploads. Core CGM metrics were analyzed based on the Asia-Pacific consensus recommendations. Statistical analyses were performed using SAS 9.4.Results: The mean Time in Range (TIR, 70–180 mg/dL) was 62.7%, with 39.6% of participants achieving TIR ≥70%. The target achievement rates for Time Below Range Level 2 (&lt;54 mg/dL) &lt;1% and Time Above Range Level 2 (&gt;250 mg/dL) &lt;5% were 75.9% and 40.4%, respectively. Participants with a diabetes duration ≥26 years exhibited the best glycemic outcomes, while those with 6–15 years showed the poorest control across multiple metrics. The mean coefficient of variation (CV) was 36.5%, with the highest variability observed in the 6–15 year group after adjusting for age.Conclusion: Overall CGM target achievement rates were suboptimal among Korean adults with type 1 diabetes. Distinct glycemic profiles were observed according to diabetes duration, highlighting the need for tailored diabetes education based on CGM data—especially for patients with 6–15 years of disease duration.